| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,716 |
4,692 |
$255K |
| 92250 |
|
4,148 |
4,119 |
$193K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,742 |
2,733 |
$170K |
| V2020 |
Frames, purchases |
7,540 |
7,414 |
$137K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,227 |
4,114 |
$110K |
| 92083 |
|
1,096 |
1,090 |
$53K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,285 |
1,193 |
$51K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,939 |
1,088 |
$40K |
| 68761 |
|
254 |
223 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,950 |
1,181 |
$15K |
| 76512 |
|
232 |
117 |
$14K |
| 92285 |
|
367 |
365 |
$13K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
787 |
475 |
$8K |
| 92060 |
|
206 |
206 |
$7K |
| 92286 |
|
70 |
70 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,960 |
1,606 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
30 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 92020 |
|
68 |
68 |
$981.67 |
| 76514 |
|
46 |
46 |
$421.92 |